Social poverty indicators with school bullying victimization: evidence from the global school-based student health survey (GSHS)

BACKGROUND

School bullying is prevalent in children and adolescents. Bullying victims are seen higher risk of negative psychological outcomes. Previously published studies suggested that social indicators may pose significant influence on bullying victimization. However, the association between social poverty and bullying victimization has not been exclusively discussed.

METHODS

In this cross-sectional study, we analyzed the association between 6 commonly used social poverty indicators (Poverty Headcount Ratio, PHR; Poverty Gap, PG; Squared Poverty Gap, SPG; monthly household per capita income, PCI; Watts' Poverty Index, WPI; the Gini Index, Gini) and the prevalence of school bullying at country level by using the Global school-based Student Health Survey (GSHS) database.

RESULTS

Altogether 16 countries were included into the final analysis, with school bullying victimization prevalence ranged from 12.9 to 47.5%. Bubble plots revealed statistically significant associations between the three indicators measuring absolute poverty level (PHR, PCI, WPI) and bullying victimization. Subsequently performed principal component regression indicated that, for all types of bullying victimization, the increase of absolute poverty level was related to elevated prevalence rates, and the association was particularly strong for verbal bullying victimization.

CONCLUSIONS

Our study results may suggest that absolute social poverty is an important parameter for constructing and implementing school bullying victimization intervention strategies and measures.

[The effect of tumor spread through air spaces on the prognosis of patients with stage Ⅰ non-small cell lung cancer: a meta-analysis]

Objective: To systematically evaluate the effect of tumor spread through air spaces (STAS) on the prognosis of patients with stage Ⅰ non-small cell lung cancer (NSCLC). Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database and VIP were searched to collect papers related to NSCLC and STAS published from the establishment of aboves databases to November 2022. Papers were screened according to the inclusion and exclusion criteria, and data were extracted. The 5-year overall survival (OS) and relapse-free survival (RFS) of stage Ⅰ NSCLC patients with or without STAS were compared. HR(95%CI) was used as effective indicator to evaluate the impact of STAS positivity on the prognosis of NSCLC. The quality of each included study was assessed using the Newcast-Ottawa Scale (NOS). Results: A total of 24 papers concerning 29 studies were included according to the inclusion and exclusion criteria, and there was no significant heterogeneity among the included papers(all I2<50%). A total of 10 883 patients with stage Ⅰ NSCLC were included in the studies, of which 3 298 (30.3%) were STAS-positive. The 29 studies showed that STAS-positive patients had a higher risk of 5-year recurrence than STAS-negative patients with stage Ⅰ NSCLC [HR=1.94(95%CI:1.74-2.16)];and a meta-analysis of 17 of the studies showed that that STAS-positive patients had a higher risk of 5-year death [HR=2.09 (95%CI:1.80-2.43)]. Compared with stage Ⅰ NSCLC patients who underwent other surgeries, STAS-positive patients who underwent sublobar resection had a higher risk of 5-year recurrence than patients with other procedures (HR=3.44, 95%CI: 2.49-4.76) and a higher risk of 5-year death (HR=3.40, 95%CI:2.05-5.64); and patients with stage Ⅰ NSCLC who had the pathologic histologic type of squamous carcinoma had a higher risk of 5-year recurrence (HR=2.48,95%CI:1.71-3.60) and a higher risk of 5-year death (HR=3.04, 95%CI: 1.90-4.86) than other patients with the type of squamous lung cancer. Conclusion: STAS positivity is a risk factor of poor prognosis in patients with stage Ⅰ NSCLC, especially for patients underwent sublobar resection or with squamous lung cancer.

Treatment Rates for Mental Disorders Among Children and Adolescents: A Systematic Review and Meta-Analysis

Importance

Mental disorders among children and adolescents are global health concerns. Published studies have provided discordant results regarding treatment rates for mental disorders among youths.

Objective

To estimate combined treatment rates for several common psychiatric disorders among children and adolescents.

Data Sources

PubMed, Web of Science, PsycINFO, Scopus, and Embase were searched from database inception until September 23, 2022, and supplemented with hand-searching of reference lists.

Study Selection

Included studies were those that used validated methods to report treatment rates for any mental disorder, depressive disorders, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and behavior disorders among children and adolescents.

Data Extraction and Synthesis

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Two reviewers independently assessed study eligibility, extracted data, and scored quality. Studies with a Joanna Briggs Institute score of 5 or more were included in the meta-analysis. Treatment rates were pooled using random-effects models. Subgroup analyses were performed to investigate the association with treatment rates of factors, such as year of data collection, World Health Organization region, age, income level, timeframe of diagnosis, informant source, service type, sample origin, and internalizing or externalizing disorder.

Main Outcomes and Measures

Treatment rates for mental disorders among children and adolescents were the main outcomes, measured as percentage estimates.

Results

Forty studies were included in the analysis, comprising 310 584 children and adolescents, with boys accounting for 39% of participants (sex was not reported in 10 studies). The pooled treatment rate was 38% (95% CI, 30%-45%) for any mental disorder, 36% (95% CI, 29%-43%) for depressive disorders, 31% (95% CI, 21%-42%) for anxiety disorders, 58% (95% CI, 42%-73%) for ADHD, and 49% (95% CI, 35%-64%) for behavior disorders. Age, income level, and region were significantly associated with the combined treatment rates of mental disorders in children and adolescents. The treatment rate for depressive disorders was higher among adolescents than children (36% [95% CI, 25%-46%] vs 11% [95% CI, 0%-25%]), whereas the treatment rate for anxiety disorders was higher among children than adolescents (64% [95% CI, 52%-75%] vs 20% [95% CI, 9%-30%]). The treatment rate for any mental disorder in lower-middle income countries was 6% (95% CI, 2%-14%), in upper-middle income countries was 24% (95% CI, 2%-47%), and in high-income countries was 43% (95% CI, 35%-52%). For depressive disorders, treatment rates were higher in the Americas (40% [95% CI, 30%-51%]) than in Europe (28% [95% CI, 13%-43%]) and the Western Pacific region (6% [95% CI, 1%-16%]).

Conclusions and Relevance

This study suggests that, in general, the treatment rates for mental disorders among children and adolescents were low, especially for depression and anxiety. Targeted intervention policies and effective measures should be designed and implemented to improve treatment rates of psychiatric disorders among youths.

Childhood maltreatment and parenting style associated school bullying in Chinese children and adolescents: An analytical epidemiology evidence

OBJECTIVE

The independent associations among childhood maltreatment (CM), parenting style, and school bullying in children and adolescents have not been adequately discussed. Epidemiological evidence of higher quality is still scarce. We intend to investigate this topic by using a case-control study design in a large sample of Chinese children and adolescents.

METHOD

Study participants were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega ongoing cross-sectional study. The combined database from four study sites was used. The population-based case-control study was individually matched by study site, age, sex, race, left-behind status, whether a single child, and whether a boarding student.

RESULTS

Cases were observed to have a significantly higher prevalence of CM, higher scores for parental rejection and over-protection, and lower scores for parental emotional warmth. Multiple conditional logistic regression revealed that CM, especially emotional abuse (EA) and sexual abuse (SA), were associated with a prominently increased risk of school bullying involvement, with adjusted odds ratio (OR) of 2.28 (95 % CI: 2.03, 2.57) and 1.90 (95 % CI: 1.67, 2.17). Subsequent analysis further corroborated the robustness of EA-bullying and SA-bullying associations. Although parenting style generally showed a weaker association with school bullying, a higher level of parental rejection was related to an increased risk of bullying victimization.

CONCLUSIONS

Chinese children and adolescents who are victims of EA or SA, or experienced a higher level of parental rejection, are more vulnerable to school bullying. Targeted interventions should be designed and implemented.

Resilience mediates parenting style associated school bullying victimization in Chinese children and adolescents

BACKGROUND

Existing evidence has shown that negative parenting style elevates the risk of school bullying victimization in children and adolescents. Resilience may play as a mediating factor in this association. However, this hypothesis has not been investigated.

METHODS

In this cross-sectional study, a total of 4582 Chinese children and adolescents had been surveyed by self-administered questionnaire. The Chinese version of Egna Minnen av. Barndoms Uppfostra (s-EMBU-C), the Olweus Bully/Victim Questionnaire (OBVQ) and the Resilience Scale for Chinese Adolescents (RSCA) were used to collect relevant information. Univariate and multiple logistic regression models were used to estimate the crude and adjusted associations between parenting style, resilience, and bullying victimization. Path analysis was used to estimate the mediation via resilience in the association between parenting style and bullying victimization.

RESULTS

After adjustment for possible covariates, the results of multivariate binary logistic regression model suggested that among all dimensions of parenting style, mother's and father's rejection were significantly associated with school bullying victimization. Path analysis revealed a statistically significant mediation of resilience in the association between parental rejection and bullying victimization, and among the five dimensions of resilience, emotion regulation, family support and interpersonal assistance accounted for the highest proportions of mediation.

CONCLUSIONS

For children and adolescents who suffered from parental rejection, building up resilience, especially those measures aiming at improving emotion regulation ability and consolidating family and peer support, might be effective in reducing risk of school bullying victimization.

Childhood maltreatment and depressive disorders in Chinese children and adolescents: A population-based case-control study

OBJECTIVE

The association between childhood maltreatment (CM) and clinically diagnosed depressive disorders (DD) in children and adolescents remains inconclusive, in large part due to a lack of high-quality epidemiological evidence. This study aimed to investigate the association between CM and DD in a large sample of Chinese children and adolescents.

METHODS

The study subjects were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), and a population-based and individually-matched case-control study design was adopted.

RESULTS

CM was in general associated with an odds ratio (OR) of 5.38 (95% CI: 3.33, 8.71) for DD in children and adolescents, and a prominent dose-response association was detected. For the five specific types of CM, emotional abuse was independently related to the highest odds of DD (OR=3.90, 95% CI: 2.75, 5.54), followed by physical neglect (OR=2.04, 95% CI: 1.45, 2.87) and physical abuse (OR=1.51, 95% CI: 1.06, 2.13), while insignificant associations were found between DDs and sexual abuse and emotional neglect. Subsequently performed stratified analyses identified noticeable effect modification by important demographic factors.

CONCLUSION

CM was significantly associated with increased risk of DD in Chinese children and adolescents. The major findings of the current study suggest that victims of CM, especially those who had been emotionally abused, were susceptible to early-onset DD. Targeted interventions should be considered.

Association between school bullying victimization and self-harm in a sample of Chinese children and adolescents: The mediating role of perceived social support

Background

Studies indicated that bullying victimization (BV) is an important risk factor for self-harm in children and adolescents. However, it is unclear whether perceived social support significantly mediates this association. This study aimed to examine the association between BV and self-harm, with a particular focus on the mediating role of perceived social support.

Methods

A population-based cross-sectional study of 4,627 Chinese students aged from 10 to 17 years was conducted in southwestern China Yunnan province. A two-stage simple random cluster sampling method was used to choose study subjects. The adjusted associations between school BV, perceived social support, and self-harm were examined by using the multivariate logistic regression models. The mediation of perceived social support in the association between BV and self-harm was evaluated by using a path model.

Results

After controlling potential covariates, BV was associated with a prevalence of increased self-harm, with an adjusted odds ratio of 1.90 (95% CI: 1.57, 2.32). Among all sources of perceived social support, only parental support played a prominent mediating role in the association between BV and self-harm, accounting for 20.73% of the explained variance. The mediation of parental support was comparable between boys and girls. As for different types of bullying victimization, path analyses indicated that only the association between physical victimization and self-harm was significantly mediated by parental support.

Conclusion

Our study results highlighted the promising interventional benefit of parental support in BV-associated self-harm risk for children and adolescents. For victims of bullying, especially physical bullying, promoting parental support might be effective in reducing self-harm risk. Longitudinal studies are warranted to further corroborate these findings.

Childhood maltreatment and suicidal ideation in Chinese children and adolescents: the mediating role of mindfulness

BACKGROUND

Childhood maltreatment (CM) has been associated with suicidal ideation (SI) in children and adolescents, yet the mediating role of mindfulness in this association remains unclear. This study aims to test the mediation of mindfulness in CM-SI association among a large sample of Chinese children and adolescents.

METHODS

A population-based cross-sectional study of 3455 children and adolescents aged 10-17 years from southwest China Yunnan province was conducted. Information from the participants was collected by using a comprehensive self-administered questionnaire. The Chinese version of the Childhood Trauma Questionnaire (CTQ), Five Facet Mindfulness Questionnaire (FFMQ), and the Beck Scale for Suicidal Ideation (BSSI) were used to measure CM, mindfulness and SI. Univariate and multivariate binary logistic regression models were used to estimate the crude and adjusted associations between CM, mindfulness and SI (one-week, one-year, lifetime). Pathway analysis was subsequently performed to test the mediation of mindfulness in CM-SI association.

RESULTS

The findings showed that mindfulness, CM and SI were significantly correlated with each other (p &lt; 0.05). Mindfulness is a significant mediator in CM-SI association, accounted for 7.5, 11.4, and 17.6% of the total associations for one-week SI, one-year SI, and lifetime SI, respectively. For the five types of CM, the highest level of mediation via mindfulness had been found for physical neglect (PN) and one-year SI (34.3%), followed by emotional neglect (EN) and one-year SI (30.2%), sexual abuse (SA) and one-year SI (25.4%).

CONCLUSIONS

Our study findings highlight the intervention potential of mindfulness in preventing CM associated suicidal risk. Future longitudinal studies are warranted to corroborate the effectiveness of mindfulness-based intervention for Chinese children and adolescents.

Mobile phone addiction and non-suicidal self-injury among adolescents in China

Background

Non-suicidal self-injury (NSSI) has recently widely discussed. Independently, mobile phone addiction (MPA) has also attracted academic attention. A few research have examined the correlation between the two. However, there is inadequate knowledge to characterize this relationship altogether. This study further explores the correlation between MPA and NSSI, specifically repeated and severe NSSI.

Method

A population-based cross-sectional survey was conducted among 2,719 adolescents in Lincang, Yunnan. The mobile phone addiction index (MPAI) and the Modified Adolescents Self-Harm Survey (MASHS) were administered in combination. The connection between the MPAI and NSSI, as well as both repeated and severe NSSI, was studied using univariate and multivariate logistic regression models. (The copyright holders have permitted the authors to use the MPAI and the MASHS).

Results

The prevalence of NSSI was 47.11% (95% CI [36.2-58.0%]), and the detection rate of MPA was 11.11% (95% CI [6.7-18.0%]). The prevalence of NSSI among those with MPA was 4.280 times (95% CI [3.480-5.266]) that of respondents not exhibiting MPA. In addition, all subscales of the MPAI, except for the feeling anxious and lost subscale (FALS), were positively correlated with NSSI. Risk factors, represented by odds ratios, of repeated NSSI with the inability to control cravings subscale (ICCS), the FALS, and the withdrawal and escape subscale (WES) was 1.052 (95% CI [1.032-1.072]), 1.028 (95% CI [1.006-1.051]), and 1.048 (95% CI [1.019-1.078]) respectively. Risk factors of these same three subscales for severe NSSI, had odds ratios of 1.048 (95% CI [1.029-1.068]), 1.033 (95% CI [1.009-1.057]), and 1.045 (95% CI [1.018-1.073]).

Conclusion

MPA was shown to be a risk factor for NSSI in adolescents. Individuals with high scores on the ICCS, the WES, and the FALS were more prone to experience repeated and severe NSSI. As a result, early assessment using the MPAI to determine the need for intervention can contribute to the prediction and prevention of NSSI.

School bullying victimization-associated anxiety in Chinese children and adolescents: the mediation of resilience

BACKGROUND

School bullying victimization is associated with increased risk of anxiety in children and adolescents. However, little is known about the role of resilience in this association. The purpose of this study was to investigate the possible mediation by resilience in this association in a large group of Chinese children and adolescents.

METHODS

A population-based cross-sectional study adopting two-stage simple random cluster sampling was implemented in Yunnan province, southwestern China. A comprehensive questionnaire was used to collect information from the participants. Among all the participants, 4624 were included in the final analysis. Descriptive statistics were used to present general characteristics of the study participants. Univariate and multivariate logistic regression models were adopted to estimate crude and adjusted associations among bullying victimization, anxiety, and resilience. A path model was used to analyze the hypothesized mediation by resilience in the association between bullying victimization and anxiety.

RESULTS

Analytical results of multivariate logistic regression models suggested that bullying victimization was significantly associated with anxiety in Chinese children and adolescents; compared with individuals who had not been bullied, victims of bullying were more likely to experience anxiety symptoms, with an adjusted odds ratio (OR) of 3.02 (95% CI 2.46-3.71). Path analysis revealed a prominent mediating effect of resilience in the association between bullying victimization and anxiety, accounting for 31.89% of the total association. Further analysis indicated that, among the five dimensions of resilience, emotional regulation, interpersonal assistance, and family support were significant mediators, accounting for 30.34%, 10.79%, and 8.35% of the total association.

CONCLUSIONS

Our major findings highlighted the promising role of resilience-based intervention measures in reducing the risk of anxiety associated with school bullying victimization in Chinese children and adolescents.

Mediation of Resilience in the Association Between Personality Traits and Suicidal Ideation Among Chinese Adolescents

A positive connection has been established between personality traits and suicidal ideation (SI). However, the possible mediation of resilience within this association has never been thoroughly discussed. In this study, we aimed to investigate this topic by using population-based cross-sectional survey data of 4,489 Chinese children and adolescents. A self-administered questionnaire was used to collect information from the participants. Univariate and multivariate logistic regression models were adopted to measure the crude and adjusted associations between personality traits, SI, and resilience. Path analysis was performed to evaluate the mediation of resilience in the association between personality traits and SI. For 4,489 study subjects, the mean age was 13.4 years, ethnic minorities accounted for 71.8%, and over a half (54.6%) were middle school students. The reported prevalence rates for 1-week, 1-year, and lifetime SI were 27.6% (95% CI: 24.9%, 30.0%), 35.5% (95% CI: 30.8%, 41.0%), and 56.7% (95% CI: 52.3%, 61.0%), respectively. Girls reported a significantly higher prevalence of SI than boys. Path analysis results revealed a prominent mediation of resilience; moreover, for different dimensions of personality traits, the proportion of mediation by resilience varied. Our major findings suggest that resilience-based intervention measures could be considered in preventing personality traits related to suicidal risk among youngsters. For children and adolescents, the measuring of personality dimensions may also be helpful in targeting key subpopulations of intervention priority.

The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China

Background

The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China.

Methods

In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents' non-suicidal self-injury behaviors.

Results

The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3-58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06-2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31-3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66-5.63])) and NSSI severity (OR 9.01 (95% CI [6.11-13.29])) were positively associated with ASLEC.

Conclusion

NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.

Resilience mediates the association between impulsivity and self-harm in Chinese adolescents

OBJECTIVE

Existing literature is supportive for the positive connection between impulsivity and self-harm (SH), nevertheless, less is known regarding to the role of resilience in this association. This research primarily explored potential mediation of resilience in the association between impulsivity and SH in a large sample of Chinese adolescents.

METHOD

A population-based cross-sectional survey of 4552 adolescents was conducted in southwest China. A self-administered questionnaire was adopted for data collection from all subjects. The Barratt Impulsiveness Scale (BIS), the Modified version of Adolescents Self-Harm Scale (MASHS) and the Resilience Scale for Chinese Adolescents (RSCA) were used to measure impulsivity, SH, and resilience, respectively. The associations between impulsivity, resilience, and SH were estimated by using stepwise multivariate Logistic regression models. Mediation of resilience in impulsivity and SH association was evaluated by using path model.

RESULTS

The prevalence of SH was 39.1% (95% CI: 34.0%-45.0%) for surveyed adolescents. Impulsivity and resilience were significantly associated with the prevalence of SH. Prominent dose-response association between impulsivity and SH prevalence was further confirmed. Resilience was a salient mediator which accounted for 42.90% of the total impulsivity-SH association. Among all the five dimensions of resilience, goal concentration (23.98%) and emotion regulation (21.94%) showed the strongest mediation.

CONCLUSIONS

The findings suggest that resilience building intervention strategies, particularly those focusing on improving goal concentration, emotion regulation, and positive perception, could be effective in reducing impulsivity related SH risk among Chinses adolescents.

Association between hypomania and self-harm behaviors in Chinese children and adolescents with depressive symptoms

Bipolar disorder (BD) is associated with a higher risk of self-harm (SH) when compared with depression. Therefore, it is reasonable to suspect that the state of mania or hypomania may independently contribute to increased SH risk. However, for hypomania, its association with SH remains less known. We intend to investigate this hypothesis in a large sample of Chinese children and adolescents with depressive symptoms. Based on a two-stage simple random cluster sampling method with probability proportionate to sample size (PPS) design, a total of 4,858 children and adolescents aged between 10 and 17 years were surveyed in southwestern China, Yunnan Province, by using self-administered questionnaires. Among them, 1,577 respondents with depressive symptoms were screened out and included in the final analysis. Descriptive statistics were calculated to illustrate the major characteristics of the study subjects. Multivariate logistic regression models were fitted to evaluate the adjusted association between hypomanic symptoms and SH. The prevalence of SH in children and adolescents with depressive symptoms was 63.92% (95% CI: 58.70-69.00%). The two hypomanic factors, which measure "active/elated" (factor I) and "risk-taking/irritable" (factor II), were significantly and discordantly associated with SH: after adjustment, every one-point increase in factor I and factor II scores was associated with 0.94-fold (95% CI: 0.91-0.97) and 1.25-fold (95% CI: 1.15-1.36) of odds ratio (OR) in SH prevalence. Further analyses based on quartiles of the two factors revealed a more prominent dose-response relationship between factor II and SH prevalence, SH repetition, and SH severity. The results of this study may suggest that, for hypomanic children and adolescents, individuals with elevated factor II score are probably of greater urgency for SH intervention. Major limitations of this study include inability of causal inference, risk of information bias, and limited results extrapolation.

Depression and anxiety among children and adolescents pre and post COVID-19: A comparative meta-analysis

BACKGROUND

Published studies in comparing pre and post the COVID-19 pandemic depression and anxiety levels among children and adolescents yielded incongruent results. Therefore, there is a necessity to perform a timely meta-analysis to synthesize existing evidence.

METHODS

A total of 10 digital databases (PubMed, Web of Science, PsycINFO, the Cochrane Library, Embase, Scopus, ScienceDirect, CNKI, WanFang, CQVIP) were fully searched for eligible studies published before November 6, 2021. Based on quality assessment results, relevant data were extracted for eligible studies of higher quality. We combined standardized mean difference (SMD) or prevalence ratio (RR) for anxiety and depression pre and post the COVID-19 pandemic by using random-effects models. Sensitivity analysis was further performed to evaluate heterogeneity of included studies.

RESULTS

14,508 articles were preliminarily identified, and after stepwise screening process, 8 articles were included eventually. The results showed that the SMD for post COVID-19 anxiety score measured by GAD-7 was 0.12 (95% CI: 0.08, 0.17), an significant increase compared with pre COVID-19 period; the SMDs and 95% CIs for post COVID-18 depression scores measured by PHQ-9, PHQ-8, and MFQ were 0.17 (95% CI: 0.10, 0.24), 0.23 (95% CI: 0.08, 0.38), and 0.11 (95% CI: 0.06, 0.17), respectively, also significantly increased compared with pre COVID-19 period. The RR for depression was 2.54 (95% CI: 2.48, 2.60) in post COVID-19 period when compared with pre-pandemic.

CONCLUSIONS

Children and adolescents reported deteriorated anxiety and depression levels after the COVID-19 pandemic. More attention should be paid to this vulnerable group. Effective, expedient, and practical intervention measures which are compatible with COVID-19 prevention and control policies should be developed and implemented to maintain mental health wellbeing of the youths.

Resilience mediates the association between self-harm and suicidal ideation in Chinese left-behind children

Background

A significant association between self-harm (SH) and suicide ideation (SI) has been found in Chinese left-behind children (LBC). Existing literature suggests that resilience might be a mediator in this association. However, this hypothesis has not been effectively discussed. The major aim of our study is to analyze the possible mediation of resilience in SH-SI association in Chinese LBC.

Methods

A population-based clustering sampling survey of 2619 LBC was conducted in southwestern China Yunnan province. Self-developed structured questionnaire was used to collect relevant information. Univariate and multivariate Logistic regression models were applied to estimate the associations between SH and SI, resilience and SI, and SH and resilience. Path analysis was adopted to measure the mediation of resilience, as well as its 5 dimensions, in the association between SH and SI. A subgroup analysis was further done to explore the mediation of resilience in the associations between SH severity and SI, SH repetition and SI, among self-harmed LBC.

Results

Compared with LBC who reported no SH behaviors, the odds ratio (OR) for SI was 3.37 (95% CI: 2.63–4.31) among self-harmed LBC. Based on the path model, resilience significantly mediated a quarter of the total association between SH and SI. Among the 5 dimensions of resilience, emotion regulation, interpersonal assistance, and family support were the strongest mediators. Subgroup analysis revealed that, the mediation of resilience was only significant for SH severity and SI.

Conclusions

Resilience played as a prominent mediator in SH-SI association among Chinese LBC. Resilience-centered intervention measures could be considered to reduce suicidal risk of this disadvantageous group.

[Incidence of unintended pregnancy within 2 years after delivery and its influencing factors in China]

Objective: To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China. Methods: Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women's socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis. Results: A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95%CI: 4.5%－6.1%) and 13.1% (95%CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions: In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

Childhood maltreatment and self-harm in Chinese adolescents: moderation and mediation via resilience

Background

Published studies examining the association between childhood maltreatment (CM) and self-harm (SH) among adolescents have been accumulated. It is possible that resilience serves as a moderator or mediator in CM-SH association, nevertheless, this topic has never been thoroughly investigated.

Methods

In this population-based cross-sectional study, we surveyed 3146 students aged 10–17 in southwest China. The Childhood Trauma Questionnaire (CTQ), the Modified version of Adolescents Self-Harm Scale (MASHS), and the Resilience Scale for Chinese Adolescents (RSCA) were used to measure CM, SH, and resilience. Correlational analyses, hierarchical multivariate linear regression, and structural equation modeling (SEM) were performed to test the moderation and mediation of resilience in CM-SH association.

Results

Findings revealed that, resilience with its five dimensions, CM, and SH were significantly correlated with each other. Resilience partially moderated and mediated the association between CM and SH. Besides, among all dimensions of resilience, emotion regulation, interpersonal assistance, and family support presented the strongest mediation in CM-SH association.

Conclusions

Our results highlight the importance of resilience in CM related SH among Chinese teenagers. Resilience-oriented intervention could be considered in SH intervention measures for adolescents who had experienced CM.

Impulsivity mediates the association between parenting styles and self-harm in Chinese adolescents

Background

Parenting styles are significantly associated with self-harm (SH) in adolescents. Nevertheless, little is known about the mechanism underlying this association. This study primarily aimed to evaluate the potential mediating role of impulsivity in the association between parenting styles and SH in Chinese adolescents.

Methods

Self-administered questionnaires were used to conduct a survey among a sample population consisting of 3146 adolescents in southwest China. Logistic regression analyses were performed to evaluate the association between parenting styles, impulsivity, and SH. A path model investigation further examined the mediating role of impulsivity in terms of the association between parenting styles and SH.

Results

The age range of participants was 10 to 17 years old. The prevalence of SH was 47.0% (95% CI: 36.3–58.0%). Impulsivity, less paternal emotional warmth, maternal over-protection, and rejection were significantly associated with SH. The path model identified impulsivity as a salient mediator, accounting for 23.4% of the total association between parenting styles and SH. The hypothesized path model indicated differences in the parenting styles of fathers and mothers: Impulsivity played a significant mediating role, though only in respect to the maternal over-protection and rejection paths.

Conclusions

For Chinese children and adolescents who experience a harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing SH related to parenting styles.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10386-8.

Cohort study to evaluate efficacy, safety and acceptability of a two-rod contraceptive implant during third, fourth and fifth year of product use in China

Objective

Sino-implant (II) is a contraceptive implant approved for 4 years of use in China. We evaluated the contraceptive efficacy during the third, fourth and fifth year, and assessed additional pharmacokinetics (PK), safety, and acceptability endpoints.

Study design

We enrolled a cohort of 255 current Sino-Implant (II) users entering their third year and a second cohort of 243 users entering their fourth year. We followed these two cohorts for 12 and 24 months, respectively. To characterize PK endpoints (i.e. levonorgestrel (LNG), sex hormone binding globulin and free LNG index) over 5 years, we collected blood samples in a subset of 50 participants we followed during the third, fourth and fifth year. We also enrolled small cohorts (n = 20) of Sino-implant (II) users entering their sixth month and second year and followed them each for up to 6 months. Our primary efficacy measures were the pregnancy Pearl Indices during Year 3 and 4. Secondary objectives included assessments of PK, safety, acceptability and efficacy in the fifth year.

Results

We recorded four pregnancies, with a higher pregnancy rate during Year 3 [1.34 (95% CI: 0.28–3.93)] than Year 4 [0.44 (95% CI: 0.01–2.47)] or Year 5 [0.00 (95% CI: 0.00–2.02)]. The overall pregnancy rate for the third, fourth and fifth years of product use was 0.63 per 100 WY; 95% CI: (0.17–1.62). Mean LNG concentrations remained well above 200 pg/mL (Year 3 = 280.9; Year 4 = 233.6; Year 5 = 270.6). Most participants (93.7%) described their bleeding pattern as acceptable.

Conclusion

Sino-implant (II) is a highly effective contraceptive method in this population of Chinese women over 5 years.

Implications

Sino-implant (II) is a highly effective contraceptive method with an estimated Pearl Index of less than 1% over the third, fourth and fifth years of use in a population of Chinese women of reproductive age.

Osteogenesis-promoting activity of composites SBA-15 mesoporous particles carrying oxytocin in vitro and in vivo

This study analyzes the performance of SBA-15 mesoporous particles carrying oxytocin (OT) in promoting osteogenesis in vitro and in vivo. The SBA-15 particles synthesized in the previous studies (about 30 μm in diameter and containing 10 nm deep pores) were loaded with the drug oxytocin and cultured with human osteosarcoma MG-63 cell line in vitro. The influence of particles on cell proliferation was studied. The level of the osteogenic marker (alkaline phosphatase and type I collagen) was measured. For in vivo studies, the connectivity defects of rabbit skull were prepared, and SBA-15 suspensions were regularly injected at the defect sites. The changes in the defect site calcium salt deposition were measured, and morphological changes were observed by microscopy. The material had to promote effect on osteogenesis-related indicators such as alkaline phosphatase and collagen I in bone sarcoma cell line MG-63. In vivo, the calcium salt deposition in OT/SBA-15 group was significantly higher than in the blank group. SBA-15 carriers appeared to persist in the region of the defect after the injection and release the drugs slowly, thus playing a more distinct role in promoting bone repair of local bone defects. The results showed that SBA-15 particles with OT could slow the release drugs and could help in promoting osteogenesis.

Insights into the potential use of microRNAs as a novel class of biomarkers in esophageal cancer

MicroRNAs (abbreviated miRNAs) have been demonstrated to be involved in tumorigenesis and cancer development and proposed as promising biomarkers in cancer diagnosis. Numerous studies have observed the aberrant expression of miRNAs in esophageal cancer. However, there are some discrepant results. Thus, we conducted this meta-analysis to identify the overall accuracy of miRNAs in the diagnosis of esophageal cancer. A comprehensive literature search was conducted in PubMed and other databases using combinations of key words. The summary receiver operator characteristic curves were plotted to assess the overall diagnostic performance of miRNAs. Chi-squared and I(2) tests were used to assess the heterogeneity between studies. Additionally, we conducted subgroup and sensitivity analyses to analyze the potential sources of heterogeneity. In total, 33 studies from 12 articles were available in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR) diagnostic odds ratio, and area under the curve were 0.80, 0.80, 4.0, 0.25, 16, and 0.87, respectively. Subgroup analyses based on the sample types (saliva-, serum- and plasma-based) showed no differences in the diagnostic accuracy of each subgroup. An independent meta-analysis of eight articles was conducted to evaluate the diagnostic accuracy of miRNAs in patients with esophageal squamous cell carcinoma, with a pooled sensitivity of 0.77, specificity of 0.83, PLR of 4.4, NLR of 0.27, diagnostic odds ratio of 16, and area under the curve of 0.87. In conclusion, this meta-analysis demonstrates the feasibility of using miRNAs as non-invasive biomarkers to discriminate esophageal cancer from healthy controls. However, further high-quality studies on more clearly defined esophageal cancer patient are needed to confirm our conclusion.

Akt inhibition attenuates rasfonin-induced autophagy and apoptosis through the glycolytic pathway in renal cancer cells

Rasfonin is a fungal secondary metabolite with demonstrated antitumor effects. However, the underlying mechanism of the regulatory role in autophagy initiated by rasfonin is largely unknown. Moreover, the function of Akt to positively mediate the induced autophagy remains elusive. In the present study, we observed that rasfonin induced autophagy concomitant with the upregulation of Akt phosphorylation. Both the inhibition of Akt by small molecule inhibitors and genetic modification partially reduced rasfonin-dependent autophagic flux and PARP-1 cleavage. The overexpression of myrAkts (constant active form) promoted rasfonin-induced apoptosis and autophagy in a cell type- and Akt isoform-specific manner. Using quantitative PCR and immunoblotting, we observed that rasfonin increased the expression of glycolytic gene PFKFB3, and this increased expression can be suppressed in the presence of Akt inhibitor. The inhibition of PFKFB3 suppressed rasfonin-activated autophagy with enhanced PARP-1 cleavage. In the case of glucose uptake was disrupted, which mean the glycolytic pathway was fully blocked, the rasfonin-induced autophagy and PARP-1 cleavage were downregulated. Collectively, these results demonstrated that Akt positively regulated rasfonin-enhanced autophagy and caspase-dependent apoptosis primarily through affecting the glycolytic pathway.

Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation

BACKGROUND AND PURPOSE

Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules.

MATERIALS AND METHODS

From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up.

RESULTS

After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P < .001), but the cost difference was not significant.

CONCLUSIONS

Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.

The roles of mesenchymal stem cells in gastric lesion and regeneration: applications in gastric diseases

In recent years, many studies have focused on the roles of mesenchymal stem cells (MSCs) due to their contribution to tissue regeneration and tumorigenesis. However, the full profile of the roles of MSCs in gastric diseases has not been established. In this review, we aim to provide an overview on the roles of MSCs on cell lesion and regeneration in gastric diseases, including gastric ulcer, premalignant conditions and cancer. We will also discuss the mechanisms underlying the behaviors of MSCs in these diseases.

Ecology-based screen identifies new metabolites from a Cordyceps-colonizing fungus as cancer cell proliferation inhibitors and apoptosis inducers

OBJECTIVES

This study aims to identify new anti-cancer agents from Cordyceps-colonizing fungi, using an ecology-based approach. It also aims to explore their anti-cell proliferative mechanisms, and to evaluate their anti-tumour effects in vivo.

MATERIALS AND METHODS

Extracts from Cordyceps-colonizing fungi were tested on HeLa cells, and active extracts were separated to obtain anti-tumour metabolites; their structures were elucidated by mass and nuclear magnetic resonance spectroscopy. Cell cycle analysis was evaluated using flow cytometry. Tumour formation assays were performed using C57BL/6J mice.

RESULTS

Based on ecological considerations, the selected extracts were subjected to initial anti-tumour screening. Bioassay-guided fractionation of the active extract afforded two new epipolythiodioxopiperazines, named gliocladicillins A (1) and B (2). (A) 1 and B (2) inhibited growth of HeLa, HepG2 and MCF-7 tumour cells. Further study demonstrated that both preparations arrested the cell cycle at G(2)/M phase in a dose-dependent manner, and induced apoptosis through up-regulation of expression of p53, p21, and cyclin B, and activation of caspases-8, -9 and -3. These data imply that gliocladicillins A (1) and B (2) induce tumour cell apoptosis through both extrinsic and intrinsic pathways. In addition, in vivo studies showed that they displayed significant inhibitory effects on cell population growth of melanoma B16 cells implanted into immunodeficient mice.

CONCLUSIONS

Gliocladicillins A (1) and B (2) are effective anti-tumour agents in vitro and in vivo and should be further evaluated for their potential in clinical use.

Induced abortion and duration of third stage labour in a subsequent pregnancy

We set out to evaluate the impact of first trimester induced abortion on the duration of third stage labour and related complications in a subsequent pregnancy. The study was conducted in Shanghai city at 15 general hospitals (or maternity and infant health institutes) from November 1993 to March 1998. We identified all nulliparae who came for antenatal care within the first 63 days of pregnancy (2953); the women were divided into two cohorts according to their previous history of first trimester induced abortion. After enrollment, the women were interviewed five times from recruitment until 42 days after delivery. We included in the study all 1363 women who had a singleton vaginal live birth. Of these women, 703 were primigravida (non-exposed), 534 had had one previous first trimester induced abortion, and 126 women had had two or more first trimester induced abortions. The duration of third stage labour in minutes was longer in women with one or more previous induced abortions (mean=7.32 minutes) compared with primigravid women (mean=6.79 minutes). Prolonged third stage labour (>30 minutes) following one or more induced abortions was seen for 3.4% versus 1.0% in primigravid women. After adjusting for a number of potential confounders, women with one or more previous first trimester induced abortions had an odds ratio of prolonged third stage labour of 2.59 (95%C.I.=1.06-6.37) compared with primigravida, especially after an interpregnancy interval of more than 6 months (OR=3.24, 95%C.I.=1.29-8.13). The odds ratio of prolonged third stage labour was 3.14 (95%C.I.=1.22-8.09) if gestational age at the time of the induced abortion exceeded 49 days. Women with a first trimester induced abortion had no significantly increased risk of postpartum haemorrhage or retained placenta. It was concluded that a history of one or more first trimester induced abortions was related to an increased risk of prolonged third stage labour in the following pregnancy, particularly if the induced abortion was performed after 49 days of gestation.

RhoA, encoding a Rho GTPase, is associated with smoking initiation

We used microarray analysis of acute nicotine responses in mouse brain to choose rationale candidates for human association studies on tobacco smoking and nicotine dependence (ND). Microarray studies on the time-course of acute response to nicotine in mouse brain identified 95 genes regulated in ventral tegmental area. Among these, 30 genes were part of a gene network, with functions relevant to neural plasticity. On this basis and their known roles in drug abuse or synaptic plasticity, we chose the genes RhoA and Ywhag as candidates for human association studies. A synteny search identified human orthologs and we investigated their role in tobacco smoking and ND in a human case-control association study. We genotyped five and three single nucleotide polymorphisms from the RhoA and Ywhag genes, respectively. Both single marker and haplotype analyses were negative for the Ywhag gene. For the RhoA gene, rs2878298 showed highly significant genotypic association with both smoking initiation (SI) and ND (P = 0.00005 for SI and P = 0.0007 for ND). In the allelic analyses, rs2878298 was only significant for SI. In the multimarker haplotype analyses, significant association with SI was found for the RhoA gene (empirical global P values ranged from 9 x 10(-5) to 10(-5)). In all multimarker combinations analyzed, with or without inclusion of the single most significant marker rs2878298, identical risk and protective haplotypes were identified. Our results indicated that the RhoA gene is likely involved in initiation of tobacco smoking and ND. Replication and future model system studies will be needed to validate the role of RhoA gene in SI and ND.

Morphological alteration and biological properties of hepatocytes not related to tumorigenesis following transfection with HCV core protein

The hepatitis C virus (HCV) core protein is supposed to play a critical role in HCV-mediated human liver disease with its capabilities to regulate the growth rate of hepatocytes and to partially contribute to the pathogenesis of hepatocellular carcinoma in association with cellular oncogenes. In this study, to analyse the possible pathological mechanism of the HCV core protein, human primary embryo hepatocytes transfected with HCV core were monitored by immunofluorescence, reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot. The morphological changes and biological properties of the transfected hepatocytes were also studied. The results showed that the HCV core gene integrated in the cellular genome and the protein expressed in the transfected hepatocyte, could be detected following serial passage at both the mRNA and protein level. The proliferation assays indicated that hepatocytes transfected with the HCV core gene alone did not exhibit any tumorigenic tendency. Meanwhile, the morphological alterations of these cells demonstrated obvious changes in size, and large vacuolar degeneration. In conclusion, the hepatocytes transfected with the HCV core gene revealed that the core protein expressed induced pathological changes of degeneration, probably related indirectly to tumorigenicity.

[Investigation on genotype constitution of different Plasmodium vivax isolates and its geographical distribution in China]

OBJECTIVE

To investigate the population constitution and geographical distribution of Plasmodium vivax in China using molecular technique.

METHODS

Blood-spot filter paper samples with related epidemiological data were collected from vivax malaria patients living in malarious area of 10 provinces (autonomous region) in China. Semi-nested- or nested-allelic-specific PCR genotyping method was used to identify CSP genotypes, families and types of Plasmodium vivax of each isolate from these patients.

RESULTS

Of 384 field isolates of Plasmodium vivax, 258 temperate zone family strains were identified, including 14 allelic variant genotypes spreading among 10 sampling provinces; allelic variants sized less than 731 bp were only seen in 5 provinces in southern China; 79 tropical zone family strains including 5 genotypes were also distributed in 5 provinces of southern China south to 25 degrees N. lat; and 14 PV Type-2 strains including 2 genotypes were found in some areas of Hainan and Yunnan Provinces. In addition, 33 isolates from genotype-mixed infections were revealed.

CONCLUSION

At present, area north to 25 degrees N. lat. of the country is the sole area prevalent for Plasmodium vivax family strains of temperate zone; there is overlapping distribution of P. v. of temperate zone family and tropical zone family of this parasite in the southern China south to 25 degrees N. lat; where the most complex isolate constitution is in Yunnan and Hainan Provinces, and PV Type-2 strains have been found in some areas of the two provinces. Besides, there were 2 groups of genotype with distinct geographic distribution feature within the temperate zone family.

Identification of a novel human sand family protein in human fibroblasts induced by herpes simplex virus 1 binding

Studies on interaction between Herpes simplex virus 1 (HSV-1) and human fibroblasts KMB-17 have demonstrated that HSV-1 binding to the cell surface could induce a specific gene response. In this study, the HSV-1 stimulation-related gene 1 (HSRG1), a new so far unknown gene function of cellular response induced by a specific stimulation with HSV-1, was cloned from the cDNA library established from mRNA of early gene response of KMB-17 cells. The gene product consisted of 547 amino acids and had a significant homology, in six eukaryotic species. On the basis of its structure it was identified as a member of the SAND protein family. The HSRG1 protein was fused with glutathione S-transferase (GST) and expressed in Escherichia coli DHPalpha strain under the control of T7 promoter. An antibody to HSRG1 raised in mice was used to detect expression of the HSRG1 protein in KMB-17 cells stimulated by HSV-1 by an immunoprecipitation assay. It was found that the HSRG1 protein was induced in these cells by HSV-1 at high level.

[Studies on identification of circumsporozoite protein genotyping of Plasmodium vivax]

OBJECTIVE

To develop a new method of genotyping circumsporozoite protein (CSP) gene for identification of field isolates of Plasmodium vivax.

METHODS

Improved Chelex-100 ion-exchange method was used to extract DNA from blood filter paper samples, nested PCR and allele-specific PCR techniques, agarose gel electrophoresis analysis and dot/southern blotting-probe hybridization were employed for amplification, resolution and identification of the diagnostic fragments.

RESULTS

Using the nest-allele-specific PCR assay reported here, small amounts of DNA extracted from a piece of blood filter paper sample were amplified which produced three different size ranges of diagnostic bands: 650-770 bp PV-species-specific band, 170-230 bp diagnostic band for temperate zone family and 588 bp band for PV type-2. The sizes and patterns of the bands produced by the reference strains were consistent with those of designed target sequences. Of 59 examined isolates from 6 provinces of China, 42 temperate zone family strains, 15 tropical zone family strains and two PV type-2 strains were identified.

CONCLUSION

1, Three genotype strains of P. vivax mentioned above could be identified by this method with only two rounds of PCR and without probe hybridization. 2, The preliminary results showed that PV type-1 including temperate zone family strains and tropical zone family strains as well as PV type-2 strains are present in China. In addition, another CSP genotype with both sequence characteristics of temperate zone and tropical zone family might also be present in China.

Infertility in Shanghai: prevalence, treatment seeking and impact

To assess the level of treatment seeking and impact on marriage of infertility among newly married couples of Shanghai, China, a total of 7872 newly married couples, enrolled between 1987 and 1988, were followed-up for 5 years. The prevalence of infertility (no fertile conception after 24 months of unprotected intercourse) was found to be 5.1%. Couples' age at marriage, education, prior induced abortion, miscarriage, use of IUD or hormonal contraceptives and medical problems of both partners were associated significantly with infertility. About 57% of infertile couples sought infertility treatment and subsequently had a higher probability of childbirth (42%) than non-seekers (28%). Husband's education, induced abortion and both partner's previous medical problems were associated significantly with infertility treatment seeking. Moreover, infertile couples were 2.2 times more likely to divorce than their counterparts (95% CI 1.52-3.18). We conclude that infertility in Shanghai is modest, but a substantial number of infertile couples would not like to seek infertility treatment. Further research is needed on this subject.

Detection of Campylobacter jejuni in poultry samples using an enzyme-linked immunoassay coupled with an enzyme electrode

An enzyme-linked immunoassay coupled with a tyrosinase modified enzyme electrode was used for rapid detection of Campylobacter jejuni. The immunomagnetic separation (IMS) method was investigated to achieve optimal isolation of C. jejuni cells. Eight types of beads with three different sizes and function groups were coated with anti-C. jejuni to isolate C. jejuni from the sample solution. Bead size and coating methods were found to be major factors that influenced the capture efficacy. Streptavidin-labeled beads (2.8 microm) provided the greatest capture ability. Three blocking reagents were tested to minimize non-specific binding. Bovine serum albumin (BSA) showed the best blocking capability. Two IMS formats were tested. Competitive immunoassay cut the detection time to 1.5 h, but the detection limit was relatively high (10(6) CFU/ml). This system was evaluated using C. jejuni pure culture and poultry samples inoculated with C. jejuni. This detection method for C. jejuni could be completed within 2.5 h and had a detection limit of 2.1 x 10(4) CFU/ml. No significant difference was found between pure culture samples and poultry samples (P>0.01). A linear relationship was found between C. jejuni cell numbers and the peak current ratio in a range of 10(2)-10(7) CFU/ml (R(2)=0.94).

Delayed induction of p38 MAPKs in reactive astrocytes in the brain of mice after KA-induced seizure

Activation of p38 mitogen-activated protein kinase (p38 MAPK) has been implicated in pathological changes in inflammatory and apoptotic processes in various cell types including neurons. Here we report the delayed induction of p38 MAPKs in the brain of mice following kainic acid (KA)-induced seizure. The immunoreactivities of p38alpha and p38beta MAPKs were markedly increased in the brain 4 days after KA administration, especially in the areas undergoing selective neuronal loss. In particular, p38beta was dramatically increased in reactive astrocytes of CA3 and CA1 regions of hippocampus with its enriched localization in the nucleus of astrocytes. The induction of p38beta was sustained for more than 10 days after KA-treatment. Pre-administration of the selective neuronal nitric oxide synthase (nNOS) inhibitor, 7-nitroindazole (7-NI), which suppressed the delayed neuronal death as well as astrogliosis in hippocampus of seizure-experienced animals, dramatically repressed the delayed induction of p38beta MAPK in astrocytes. The repression was reversed by the co-injection with L-arginine (L-arg), a substrate for NOS, which coincided with the aggravation of neuronal death. Together, these data suggested a role of p38 MAPK signal pathway in delayed neuronal death and/or in reactive gliosis in mice with KA-induced seizure.